57 analyst jobs found in Detroit

Department Summary  This position is dedicated to the State of Michigan account. The analyst responsibilities will include: Respond timely to membership and claim related escalations from customer for Blue Cross or BCN members Investigate and resolve membership discrepancies Investigate and resolve COB inquiries Investigate and resolve Medicare eligibility inquiries Assist with presenting at Benefit Open Enrollment and retiree meetings Demonstrated ability to function as an engaged and positive ambassador of BCBSM/BCN with attitudinal qualities to service and retain our State of Michigan customer Occasional travel is required    Department Preferences Bachelor’s degree preferred Three years’ customer service and/or membership experience preferably in the State of Michigan department with state benefits knowledge Working knowledge and experience in NCOMPASS/MEMBERSEDGE/FACETS/MARX Ability to provide root cause analysis to claims and membership problems Strong...

Position Summary Responsible for planning, organizing, directing, and executing complex analytical initiatives that support Health Care Value programs and performance management activities. This position operates with a high degree of independence and is responsible for researching, analyzing, and interpreting healthcare data to identify trends, evaluate program performance, quantify savings, and provide actionable business recommendations. The Senior Healthcare Analyst partners with internal stakeholders, vendors, providers, and leadership teams to develop analytical solutions, monitor contractual performance, and deliver strategic insights that improve healthcare affordability, quality, and operational effectiveness. Key Responsibilities Healthcare Analytics & Performance Measurement Lead the research, analysis, and evaluation of healthcare claims, authorization, utilization, provider, and membership data to identify trends, risks, and opportunities....

The Expert Analyst is responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.  This role also coordinates projects for senior management. Develops documentation, reports and presentations for all levels within the organization including executive leadership. Demonstrates ownership of assigned analyses from data pull through validation, summary of findings, and final deliverable. Summarizes analytical findings clearly, including approach, key observations, conclusions, and business implications. Performs data validation and quality checks to ensure accuracy, completeness, and consistency of reporting outputs. Responsible for trend analysis, report development, ad-hoc analysis and support Develop and present complex analytics concisely for consumption by upper management and Executive leadership Conduct healthcare analytics to evaluate quality performance, member outcomes,...

Provides technical, data and analytical support to customer departments such as Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment and HCV.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned.  Leads or participates, with some direction, in projects where data solutions are necessary. Provides programming and data expertise for simple and moderately complex projects and ad-hoc requests.   Presents data and solutions to internal and/or external customers in a logical way. Provides data support and analysis for programs supporting over 4 million BCBSM beneficiaries using administrative claims and supplemental data.    Provides analysis and data support for various corporate departments including Quality, Risk Adjustment, Value Partnership, Care Management, and Hospital Contracting, in support of major corporate initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS and...

Responsible for planning, organizing, directing, implementation, and leading department assignments.  Position operates within broad objectives to ensure optimum utilization of manpower and budget.  Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements. Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues. Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies. Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters. Develop lines of communication to discuss/review results of analysis to management via reports/presentations and...

**Requires travel throughout the state   Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.  Coordinate projects for senior management. Research, analyze, identify, and evaluate data from assigned problems to evaluate existing and potential trends and issues. Possess and maintain a comprehensive understanding and knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies. Assist in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters. Communicate results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions. Recommend, communicate, and implement solutions to...

Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality. Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance. Compile and analyze operational data to identify and resolve business problems. Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status updates on projects and issues. Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures. Create and present reports and presentations to display operational...

Why GM Financial Protections? GM Financial is targeting significant growth as it transforms the Protection/Insurance Products into a full captive platform. Our team is responsible for bringing the branded General Motors F&I products to market and we work hands on with our dealer partners to improve performance in their F&I department, and market our products direct to consumer. At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity and creates a sense of community and belonging. Here we do more than work — we thrive.   Our Purpose: We pioneer the innovations that move and connect people to what matters.  About the role: GM Financial is currently seeking a senior data and analytics professional with proven experience analyzing and reporting on marketing and digital marketing performance, delivering actionable insights, and driving business outcomes at GM Protection business within GM Financial....

The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at BCBSM. Assist in preparing information and research materials to identify business problems, offer recommendations and assist  management with implementation of solutions.  Support leaders on projects designed to enhance the overall efficiency and effectiveness of the organization. Develop and maintain a solid understanding of BCBSM business, products, programs, data, organizational structure, controls, research.  Analyze...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location: Dearborn, Michigan   Position Schedule / Shift: Rotating hybrid schedule Monday – Friday: 8:30 AM EST – 5:00 PM EST. In office reporting will rotate based on role responsibilities. All employees will be notified of in office reporting days as applicable. Training for this position will be in office for the first initial 90 days of employment. Rotating schedule will begin after training is completed. Position Summary: Join our Claims team in a role where your analytical skills, attention to detail, and problem-solving abilities make a direct impact on the customer experience and the financial integrity of our claims operations. As a claims operations professional, you'll take ownership of complex payment and reconciliation processes, resolve challenging issues, and serve as a trusted resource for teammates while helping ensure accurate, timely claim outcomes. If you...

Department Preferences Majors in Business or Strategy preferred Experience with AI tools, data analytics, presentation development and delivery Has a strong attention to detail Proficient in Excel and PowerPoint   The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at BCBSM. Assist in preparing information and research materials to identify business problems, offer recommendations and assist  management with implementation of solutions.  Support leaders on projects...

The Instructional Designer is responsible for designing learning experiences that solve business problems through the thoughtful combination of communications, eLearning, instructor-led training, performance support and other interventions. They ensure that high-quality, innovative, and effective learning solutions are designed, developed, and delivered by different teams in a timely manner to satisfy business needs. Engage with stakeholders from different parts of the business to rapidly analyze their needs and design high-level learning solutions that may include a range of low, medium and high-fidelity learning interventions   Plan, coordinate, and develop support materials and communications for divisional and/or corporate projects.   Report project statuses to various levels of management.   Develop performance-based training and development systems to meet operational needs and requirements.   Develop cross-trainings for various employees to carry...

Departmental Preferred Qualifications: Leads complex, cross-functional projects and coordinates internal and vendor resources. Manages project scope, timelines, budgets, risks, metrics, testing, implementation, and deliverables. Resolves barriers, improves processes, and ensures quality execution. Demonstrates NASCO system and operational knowledge, including GDO and SBP projects. Provides expertise in MAPPO, Commercial, HMO, and PPO products. Manages benefit administration, implementation, configuration, validation, and testing. Demonstrates strong organizational skills and sound judgment in ambiguous situations. Possesses customer service knowledge and may guide or supervise staff while performing other assigned duties. Communicates effectively and confidently with external customers and organizational leadership.   Accountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more...

Join the Health Care Value Strategic Informatics and Program Performance team where you will be responsible for leveraging advanced analytics, predictive modeling, and data visualization to generate actionable insights that improve healthcare outcomes, optimize program performance, and support strategic decision-making. This role partners with business leaders, clinical teams, pharmacy services, and operational stakeholders to analyze healthcare data, identify trends, evaluate program effectiveness, and provide data-driven recommendations related to cost, quality, utilization, and member outcomes. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Analyze large volume of health care claims data using advanced statistics/machine learning methods to understand existing and predict future health care trends and anomalies. Proactively discovers potential areas for medical cost improvement and management/healthcare initiative strategies....

SUMMARY:  The purpose of the Medicare Part D PGY1 residency program is to empower and educate the resident in all areas of Medicare Part D practice, including but not limited to:  • Formulary Management (including Rebates)  • Pharmacy and Regulatory Compliance and Audit  • Pharmacy Benefits Management  • Clinical Pharmacy Programs  • Plan Performance and Quality Assurance  • Medicare Part B and D Prior Authorizations and Appeals  • Product Development  • Administration and Leadership  RESPONSIBILITIES/TASKS:  • Assist Senior Leadership in the planning, development, and implementation of Medicare Part D products, programs, and services such as submission of the CMS bid.  • Help to develop, implement and maintain utilization management and drug utilization review programs.  • Serve as a key clinical support person for processing drug information inquiries.  • Participate in the Pharmacy & Therapeutics committee, making both clinical and financial formulary...

Responsible to plan, organize, control, direct and lead sales office and/or specialized sales area.  Accountable for development, planning and leadership to ensure increasing market share and membership for BCBSM and/or BCN to meet corporate goals and objectives.   Plan, organize, and direct activities of an assigned business area including but not limited to planning, training, motivation, staff development, staff selection and communication.     Develop sales and customer relation strategies for sales teams and/or customers and coordinate problem resolution to ensure that objectives are met, and problems are resolved to the benefit of customers, agents and the corporation.   Monitor and communicate to BCBSM and/or BCN management competitive products, practices, trends, attitudes and issues of customers, labor, community leaders, etc. Develop plans that ensure cohesive working relationships between constituents to maximize sales potential.     Ensure prompt,...

Department Preferences Experience creating training materials, presentations, job aids, videos, infographics, or digital content Strong written communication, editing, and content development skills Ability to analyze data, interpret results, and create reports or dashboards   The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at BCBSM. Assist in preparing information and research materials to identify business problems, offer recommendations and assist  management with...

  Responsible for planning, coordinating and supervising assigned department(s)/area(s) to ensure an efficient and cost-effective area of responsibility in accordance with established corporate and departmental policies and procedures.   Supervise and promote the professional development of assigned staff through selection, development, and exploration of more effective methods of managing projects and time. Research (internally and externally), initiate, and plan strategic changes in assigned department(s)/area(s) to optimize technologies and personnel. Recommend and assist in acquisition of technology and other tools or equipment and resources to optimize departmental performance and output. Prioritize and assign work to employees and initiate corrective measures to resolve problems, including scheduling or adjusting overtime requirements as necessary. Interface with diverse levels of internal and external personnel to develop and maintain effective rapport and to...

Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity. We will only consider candidates who are currently authorized to work in the United States and who will not require sponsorship now or in the future. Please note: student visas, CPT, OPT, H-1B, TN, and other temporary work authorizations are considered restricted forms of employment eligibility. Once these expire, the candidate must be able to present another valid form of work authorization.   Contract Dates: June 2027 through August 2027 Other hiring locations for this role are: Boston, MA; New York, NY; Atlanta, GA; San Francisco, CA; Houston, TX; Dallas, TX We are in the business of transforming tomorrows. Join us and transform yours.   The Business   Create your future. In Health & Benefits (H&B), our purpose is that through our colleagues we help our clients make a difference in the lives of their employees. We help large and mid-size...

This position is responsible for planning, organizing, and monitoring the audit coordination processes for the OGACC - Office of the General Auditor & Corporate Compliance – Emerging Markets (OGACC – EM). This position interacts routinely with the Company executives, directors, and managers, as well as BCBSM. This role requires exercising discretion and judgment in assisting the general auditor and internal audit staff. Discretion and judgment are also required when communicating with executives and staff throughout the enterprise and BCBSM. This position performs executive support tasks which may be highly confidential and sensitive in nature utilizing considerable independent judgment. Performing high-level administrative work, including organizing, scheduling, coordinating, researching, compiling, exchanging, and sometimes analyzing information for executive(s) and the department is also required. Leads on-site audit activities between OGACC - EM and the enterprise....